Study of non-alcoholic fatty pancreatic disease among the Egyptian population and the value of serum fatty acid binding protein-1 (FABP-1) as a non-invasive biomarker - 24/05/24
Highlights |
• | Our study highlighted that the NAFPD is an emerging area of interest for healthcare providers, particularly due to its association with metabolic syndrome, pancteatitis, ocal pancreatic enlargement, pancreatic cancer and other comorbidities. |
• | Future research with larger sample sizes and standardized diagnostic methods can help to better understand the epidemiology, pathogenesis, and management of NAFPD. |
• | Additionally, longitudinal studies can provide insights into the natural history and progression of NAFPD, particularly in relation to the development of metabolic and cardiovascular complications. |
• | However, there are some limitations of our study and are important to acknowledge in interpreting the results. First; a small sample size. Second, the diagnosis of NAFPD was conducted only by the method of ultrasound and it may be interfered by intra-gastrointestinal gas, obesity, and the interobserver variability of examiners. |
• | In future studies, it may be beneficial to increase the sample size and use multiple imaging modalities to improve the accuracy of diagnosis. |
• | Additionally, efforts to standardize diagnostic criteria and reduce interobserver variability may also improve the reliability of NAFPD diagnosis. |
Abstract |
Background |
Non-alcoholic fatty pancreas disease (NAFPD) can be detected using various imaging techniques, but accurately measuring the amount of fat in the pancreas remains difficult. Fatty acid binding protein-1 (FABP-1) is a marker specific to certain tissues and can aid in diagnosing NAFPD. However, this study aimed to investigate the prevalence of NAFPD among obese and non-obese people with and without diabetes mellitus (DM). Additionally, it aimed to evaluate the associated risk factors for NAFPD and the utility of the FABP-1 level as a simple, non-invasive biomarker for diagnosing NAFPD.
Methods |
This study is a prospective cross-sectional study.
Results |
Ninety-five patients were enrolled in the study, comprising 35 males and 60 females, with a mean age of 44 years and a standard deviation (SD) of 11 years. However, 26.3 % were morbidly obese, 22.1 % were severely obese, 31.6 % were obese, 12.6 % were overweight, and 7.4 % were normal. Additionally, 35.8 % had diabetes mellitus, while 26.3 % of patients had hypertension. Regarding the ultrasonographic findings, 94.7 % of the patients had fatty liver, with the majority (41.1 %) classified as grade II, followed by 38.9 % classified as grade I, and 14.7 % classified as grade III fatty liver. Among these patients, 78.9 % had fatty pancreas, with 38.9 % classified as grade II, 31.6 % classified as grade I, and 8.4 % classified as grade III fatty pancreas. The median FABP-1 level among patients with fatty pancreas was 3.3 ng/ml, which exhibited a significant fair negative correlation with total bilirubin and a fair, positive correlation with alkaline phosphatase and portal vein diameter. A statistically substantial distinction was observed between the levels of AFABP-1 and the presence or grading of the fatty pancreas (p-value = 0.048 and < 0.001, respectively). Using multivariate analysis, FABP-1 was the only significant predictor of a fatty pancreas. The receiver operating characteristic (ROC) curve analysis indicated that at a cut-off point of FABP-1 of ≤ 3.7, it had a sensitivity of 58 %, specificity of 80 %, positive predictive value (PPV) of 96.6 %, negative predictive value (NPV) of 17 %, and an area under the curve (AUC) of 0.77.
Conclusion |
NAFPD is becoming an increasingly significant challenge. FABP-1 can potentially be a straightforward and non-invasive predictor of the fatty pancreas.
Le texte complet de cet article est disponible en PDF.Keywords : Non-alcoholic fatty pancreas (NAFPD), Fatty liver, Fatty acid binding protein-1 (FABP1)
Abbreviations : NAFPD, FABP1, NAFLD, PPV, NPV, CT, BMI, CBC, IR, ELISA, OR, FP, MetS, T2DM, POPF
Plan
Vol 48 - N° 6
Article 102364- juin 2024 Retour au numéro
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